AHA Coding Clinic® for HCPCS - 2003 Quarter 1; FOR your INFORMATION
Reporting active wound care services
In a recent program memorandum, transmittal A-02-129, the Centers for Medicare & Medicaid Services (CMS), published information regarding billing for active wound care procedures. Active wound care management is reported with CPT codes: 97601—Removal of devitalized tissue from wound(s); selective debridement, without anesthesia (e.g. high pressure waterjet, sharp selective debridement with scissors, scalpel and tweezers), including topical application(s), wound assessment, and instruction(s) for ongoing care, per session 97602 —Removal of devitalized tissue from wound(s); non-selective debridement, without anesthesia (e.g. wet-to-moist dressings, enzymatic, abrasion), including topical application(s), wound assessment, and instruction(s) for ongoing care, per session...
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Article Overview
This article explains CMS guidance on reporting active wound care services and how related CPT-coded procedures are treated in Medicare outpatient billing. It is aimed at coding, billing, and reimbursement professionals who need to understand the general framework for active wound care reporting, documentation, and payment handling in clinic, emergency, and hospital outpatient settings. The article also references a CMS program memorandum and discusses how the guidance relates to outpatient visit coding and packaged payment concepts.
Why This Topic Matters
Accurate reporting of active wound care services affects claim submission, documentation alignment, and whether payment is separately recognized or bundled in outpatient settings. The article is relevant for anyone coding wound care services under Medicare rules.
What You Will Learn
- How CMS discusses active wound care service reporting
- How outpatient payment treatment is described for these services
- How documentation considerations relate to concurrent visit coding
- How hospital outpatient billing is framed when wound care is the only service provided
Who Should Read This
- Medical coders
- Outpatient billers
- Revenue cycle staff
- Compliance staff
- Health information management professionals
Codes Discussed
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